THE FREQUENCY OF INTRATHYROIDAL ADENOMAS OF THE PARATHYROID GLAND IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM

AUTHORS:
M. Parezanovic (Belgrade, Serbia) , M. Jovanovic (Belgrade, Serbia) , G. Zoric (Belgrade, Serbia) , B. Odalovic (Belgrade, Serbia) , N. Slijepcevic (Belgrade, Serbia) , K. Taušanovic (Belgrade, Serbia) , B. Rovcanin (Belgrade, Serbia) , M. Buzejic (Belgrade, Serbia) , D. Vucen (Belgrade, Serbia) , B. Stepanovic (Belgrade, Serbia) , J. Ilic (Belgrade, Serbia) , S. Ivaniš (Belgrade, Serbia) , M. Marinkovic (Belgrade, Serbia) , V. Živaljevic (Belgrade, Serbia)
Background:
Primary hyperparathyroidism is a condition characterized by increased secretion of parathyroid hormone. The most common cause is a parathyroid adenoma. Due to close embryological origin, during development, intrathyroidal localization of the parathyroid glands may occur. The aim of the research was to determine the frequency of intrathyroidal localization of parathyroid glands in patients with primary hyperparathyroidism.
Methods:
A retrospective study was conducted, involving surgically treated patients with primary hyperparathyroidism at the Clinic for Endocrine Surgery, University clinical centre of Serbia, from 2010 to 2022. The study included all patients with primary hyperparathyroidism in whom intrathyroidal localization of the parathyroid gland was definitively confirmed by histopathological examination. Demographic data, preoperative and postoperative levels of calcium, phosphate, parathyroid hormone, as well as data on the size of the parathyroid gland, were collected.
Results:
During the investigated period, 1371 patients were operated on at the Clinic for Endocrine Surgery due to primary hyperparathyroidism. Intrathyroidal localization of the hyperactive parathyroid gland was confirmed in the histopathological findings of 14 patients, accounting for 1.02% of the total number of patients operated on for primary hyperparathyroidism. The majority were females, 12 (85.71%). The average preoperative calcium level was 2.82 mmol/L, PTH 232 ng/L. In all subjects, the pathological substrate was a parathyroid adenoma, while one patient had both adenoma and hyperplasia. Adequate reduction in postoperative biochemical findings occurred in all patients.
Conclusions:
The frequency of intrathyroidal parathyroid glands is low, but they should be taken into account during preoperative preparation as well as during the operation